Dilated Cardiomyopathy Flashcards
what is it?
This is a dilated flabby heart of unknown cause
what are the associated of DCM? 8
alcohol, hypertension, haemochromocytosis, viral infection, autoimmune, peri- or postpartum, thyrotoxicosis, congenital (X-linked)
more common in males , true/false?
true
which genes are mutated?
Sarcomere and desmosomal
laminA/C and desmin mutation if there is ______ disease
laminA/C and desmin if there is conduction disease
mutation in _____ if X linked?
dystrophin
what are the risks with DCM?
- Atrioventricular block (first degree heart block)
- SVT and VA
- High risk of SCD
+/-neuromuscular symptoms
what are the symptoms? 6
- fatigue
- dyspnoea
- pulmonary oedema
- RVF
- Emboli
- AF, VT arrhythmias
what are the signs of DCM? 1-
- increased pulse, decreased BP
- increase JVP
- displaced diffuse apex
- S3 gallop rhythm
- mitral or tricuspid regurgitation
- pleural effusion
- oedema
- jaundice
- hepatomegaly
- ascites
what investigations should be done?
- blood
- CXR
- ECG
- ECho
in blood tests plasma ___ is sensitive and specific for diagnosing HF
BNP
in blood tests decreased __ indicates poor prognosis
Na
what are you loooking for on CXR?
cardiomegaly, pulmonary oedema
what may be some features of ECG?
- tachycardia
- non-specific T wave changes
- poor R wave progression
what are you looking for on echo?
- globally dilated hypokinetic heart and low ejection fraction
- Look for MR, TR, LV mural thrombus
what is the treatment?
- bed rest
- drugs
- biventricular pacing
- ICDs
- cardiac transplantation
which drugs may be used?
diuretics
- digoxin
- ACEi
- anticoagulants
when should ICD be considered?
in patients with DCM and a confirmed disease causing LMNA mutation and clinical risk factors:
- male
- NSVT
- missense mutations
- LVEF
